Mississauga Chiropractor Presents: Torticollis

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Here’s another blog from a Mississauga Chiropractor…

Torticollis is the rotation & lateral bending of the head due to cervical muscle spasms or other head & neck disorders. Synonyms:  wryneck or cervical dystonia

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Types:

  • Acquired Torticollis:
    • Transient spasmodic torticollis (< 6 months duration)
    • Idiopathic spasmodic torticollis (> 6 months duration)
  • Congenital Torticollis (born this way)

 

Acquired Torticollis:

  • Frequency: 3/10,000; gender: female > males (4.5:1)
  • Age: 90% of the cases occur between ages 31-60

 

Congenital Torticollis:

  • Occurs in newborn (fewer than 0.4%)
  • May be due to birth trauma or intrauterine malpositioning of the SCM muscle
  • Healthy at delivery à over days/weeks develop soft-tissue swelling over injured SCM à a fibrous band develops in place of SCM, causing a contracture of the neck

 

Potential Causes:

  • Muscular damage from inflammation (cervical sprain/strain)
  • Cervical spine injuries (disc herniation, facet irritation, joint restriction)
  • CNS infection, ocular disorder
  • Cervical spondylosis

 

History:

  • Neck Rotation, head tilting & slight flexion is common presenting position
  • 17% report a recent prior head & neck trauma
  • 50% of patient report neck pain
  • Up to 25% of patients do not realize their head is tilted until informed by others

 

Presentation:

  • Limited cervical active & passive range of motion
  • Severe muscle spasms & hypertonicity of the SCM, levator scapulae, scalenes, trapezius muscles

 

Management:

  • Muscle stretching techniques
  • Massage Therapy, Soft Tissue Therapy
    • Myofascial trigger points, myofascial release, relaxation massage
  • Cervical spine adjustments and/or mobilizations
  • Acupuncture
  • Electrotherapy
  • Home Care:
    • Address postural imbalances (avoid consistely sitting or reading in the same position & other work position issues)
    • Stretching & range of motion exercises, isometric resisted contraction exercises

 

Prognosis:

90% of patients with congenital muscular torticollis respond to passive stretching within the first year of life

 

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